Acquisition of Helicobacter pylori infection in a high-risk population occurs within the first 2 years of life

Abstract

Objective: To elucidate age at acquisition of Helicobacter pylori infection, we conducted a study in a population of children known to be at high risk for H pylori infection.

Method: Children with no symptoms who were of Turkish nationality and living in the city of Ulm, Germany, and nearby communities and on whom routine health screening examinations were performed at age 1 year (56 children), 2 years (55 children), or 4 years (69 children) were included in this cross-sectional study. Stool samples were collected by the parents and sent by mail to the University of Ulm. An H pylori antigen enzyme immunoassay for the detection of H pylori in stool was used to define current infection status. Sensitivity was 84.6% (95% CI 63. 1% to 94.7%) and specificity 97.7% (95% CI 86.2% to 99.9%) in the 4-year-old children in whom the stool test was compared with the (13)C-urea breath test.

Results: The prevalence of infection was 8. 9% (95% CI 3.0% to 19.6%) among the 1-year-old children, 36.4% (95% CI 23.8% to 50.4%) among the 2-year-old children, and 31.9% (95% CI 21.2% to 44.2%) among the 4-year-old children.

Conclusion: In this high-risk group of Turkish children living in Germany, H pylori acquisition seems to occur mainly between the first and the second years of life. Therefore preventive measures such as vaccination necessitate application early in infancy. Further studies are now required to ascertain the mechanisms for transmission in this age group.